MOPE086 - Poster Exhibition
Incident bone fracture in men with, or at risk for, HIV-infection in the Multicenter AIDS Cohort Study (MACS), 1996-2011
V. Walker Harris1, K. Althoff2, S. Reynolds2, F. Palella3, L. Kingsley4, M. Danielson5, J. Lake6, T. Brown1
1Johns Hopkins Univ. School of Medicine, Medicine, Baltimore, United States, 2Johns Hopkins Bloomberg School of Public Health, Epidemiology, Baltimore, United States, 3Northwestern University Feinberg School of Medicine, Infectious Diseases, Chicago, United States, 4University of Pittsburgh School of Medicine, Infectious Diseases and Microbiology, Pittsburgh, United States, 5University of Pittsburgh School of Medicine, Infectious Diseases, Pittsburgh, United States, 6University of California at Los Angeles, Medicine, Los Angeles, United States
Background: Limited data are available comparing fracture
incidence in HIV-infected (HIV+) and demographically similar HIV-uninfected
Methods: Between October 1996 and 2011, fractures related
to osteoporosis according to the FRAX definition (i.e. fracture of the hip,
humerus, forearm, or spine) were prospectively reported or recalled during
semi-annual study visits among men ≥30 years of age. Crude incidence rates (IR) per 100 person-years (PY),
adjusted rate ratios (aIRR), and 95% confidence intervals ([,]) were estimated
using Poisson regression models with an interaction term for age (30-49, 50-64,
≥65 years) and HIV status.
Results: Among 5,106 men during 73,548 person-visits, 103 FRAX-defined fractures (53 HIV+, 50 HIV-) were reported. The crude IR of FRAX-defined fracture was 0.15 fractures/100 PY in HIV+ and 0.13 fractures/100 PY in HIV- men. After adjusting for body mass index (BMI) and race, the incidence rate of FRAX-fracture increased with age (30-49yo: reference; 50-64yo aIRR=1.19 [0.78, 1.83]; ≥65yo: aIRR=2.93 [1.48, 5.80]) and HIV-infection (IRR=1.38 [0.93, 2.04]). The interaction of age and HIV status approached statistical significance (p=0.14). Compared to HIV- men age 30-49, the incidence rates of FRAX-defined fracture increased with age and were higher in HIV+ men compared to HIV- men, after adjustment for BMI and race (figure).
Figure: Incidence rate ratios and 95% confidence intervals for FRAX-defined fractures in HIV+ and HIV- men in the Multicenter AIDS Cohort Study, by age and HIV status
Conclusions: The rate of incident FRAX-defined,
osteoporosis-related bone fractures in HIV+ and HIV- men increased with
age. The increasing fracture rate
is apparent in HIV+ men at younger ages as compared to HIV- men. These data
provide support for recommendations for osteoporosis screening in HIV-infected
men between ages 50-70 years.
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